Tag Archives: diabetes care

The road to health is often lonely (Thanks to Renjith Krishnan for the image)

I often say that acceptance is the key to beginning to really manage one’s diabetes. You have to work it, not fight it. A part of accepting your diabetes is to accept the fact that you have to be different. This, as you know, isn’t easy. We humans like to follow each other, hang out together and do similar activities. We feel comfortable and cozy this way. So when it comes to those who best manage their diabetes, one thing I’ve noticed them doing is standing alone on many of the things they do. They have the strength and confidence to do so. Don’t you think?

I did this for a whole year. I tested maybe 50 times one year. Really. Amazingly, my A1c stayed between 6% and 6.5%. (Read on to find out why this wasn’t a reason to celebrate in my case).

I didn’t mean to not test. I was particularly depressed about 8-9 years ago. I was having panic attacks and a sure fire way to one was to test. So I didn’t.

I went by “feeling” what my blood sugar was. This works to some extent but I don’t recommend it and it doesn’t come close to replacing testing with a meter.

We diabetics go through the same motions over and over again so of course it is tempting to “guess and test”. We have had a blood sugar reading of 200 countless times and by now almost swear up and down we know what it feels like. We also know what a low blood sugar feels like.

Yet, I’ve found that for me personally, about 20% of the time I’m wrong! This has led to a large amount of unnecessary highs and lows. These feel worse than others because they were preventable and so I tend to kick myself when I let these happen.

So my reminder to you is that your best tool (aside from insulin of course) is your meter. It may not be as accurate as we like. It may not be convenient to carry with you (guys, we gals feel you on this one seeing as you don’t carry purses…). But, the truth of the matter it is a wonderful thing to know what your blood sugar is before you do anything like give insulin or eat some sugar.

You will probably find that cutting out this bad habit will positively affect your A1c. And you know what? You’re A1c might be the same but it will reflect where you normally stand blood sugar-wise instead of showing an average of lots of highs and lows-as my A1c did that awful year. I wasn’t proud of those A1c’s.

So let this serve as a helpful reminder to replace this bad habit with the good habit of testing often or as needed. Definitely don’t do what I did. I consider it a miracle that I’m even here telling you about it.

I think I’m entirely too sensitive. I’ve always been very emotional, have always dealt with sensitive skin, and have always responded to about half the normal dose of any medication (Seriously, you don’t want to see me on morphine pills).

So naturally, with caffeine, I’ve got to be careful. Why you ask?

Well, like many people I love coffee in the morning (or noon…or at night) and I don’t like the taste of decaf.

Yet, I’ve found that if I have too much coffee, I begin getting symptoms much like those I get when my blood sugar is low. You know, shaky, irritable, anxious, fast heart beat…

Lately I’ve been enjoying 2 cups of coffee a day. This is better than the 4-6 cups (hello, psycho!) I used to have years ago but, I think it is still too much-for me anyway. During my pregnancy and while breastfeeding I had absolutely zero caffeine. For the first time in many years I was caffeine free and I was amazed at how body felt so relaxed, my heart didn’t race, and I believe I was even more patient with everything.

The biggest thing was I didn’t confuse the caffeine overdose with low blood sugar symptoms. It was nice. Lets face it, sometimes we eat something when we feel low without testing first because we’re sure we feel low. Then this leads to high blood sugars because we were not really low. Now we’re just mad because we ruined a perfectly good blood sugar level.

Lately I’ve done this a couple of times. Also, when I eat meals I eat them so fast because I’m all wired and the fastest thing on me seems to be my jaw. I’ve noticed the more days I consecutively drink coffee the worse my symptoms. The more I snap at my husband. If I take a day or two off in between days when I do drink coffee I feel almost normal.

So I’m really wondering…does anyone else experience this with caffeine? Or is it just me and I should quit coffee altogether before I start biting off heads or find myself testing every hour because I feel low all the time?

Maybe I should buy myself a cute little coffee cup that can only hold a tiny bit of coffee and limit myself to that each day?

Perhaps my most controversial post ever, let me begin by saying this is not about bashing insulin pumps. I think they are a nice tool and a great piece of technology. They’re just not great enough for me to use.

Nothing can compare to a fully functioning pancreas (duh) but, I find it interesting that most people I have talked to who have insulin pumps say they couldn’t live without it. They mean it, too! I understand. I used to feel this way. Yet, now that I’ve been off of the pump for a few years I realize I felt that way because of fear. I can assure you there is nothing to be afraid of. Please read on to find out what exactly I’m making a fuss about.

I recently heard someone say, “if you aren’t on the pump you must be crazy!”

Oh really? Let’s be more open minded here. First of all, why does it matter to me that people out there feel this strongly about having a pump? Well, because of the negative power these words might have on an individual who cannot afford a pump or who for some reason or other cannot get access to one. People should know it is very possible to manage their diabetes without one if that is the hand they are dealt at the moment. I would hate to think some people out there feel they don’t have good control over their diabetes because they can’t get a pump. This isn’t true but, they might be lead to believe it is. They need empowerment and those of us who feel strongly about using all that modern technology has to offer should think twice before speaking.

Even my own doctor (I refer to him as my ex-doctor) laughed at me when I told him I wanted to get off of the pump. He said, “nobody goes backwards, people always want to seek to improve their blood sugars, not disturb them”. He disturbed me! What ignorance! (Its ok, he wrote about me later as a case example of a diabetic who did better coming off of the pump-although he still doesn’t understand how or why)

How come I have A1c percentages in the 4-5% range (non-diabetic range) without a pump? Is it assumed I’m doing something wrong? I assure you my blood sugar is typically around 100 instead of swinging up and down. So, there is one person’s proof they can do very well without a pump. What about others? Mary Tyler Moore doesn’t have one. Many professional athletes don’t either. Does this mean they are crazy or that their diabetes management is out of control? I doubt athletes can perform well without controlled blood sugars.

There are valid reasons to choose not to have an insulin pump and those reasons should be recognized.

After several years scar tissue buildup becomes a serious issue for many people on the pump, causing changes in insulin absorption. The famous Dr. Bernstein has said that after about 7 years on the pump, scar tissue is likely unavoidable and a real barrier against insulin absorption. Interesting…I found my glucose numbers swinging mysteriously during my 6th consecutive year on the pump and decided to switch back to prehistoric syringes after 7 years. Those glucose numbers stabilized with syringes. Dr. Bernstein in fact, doesn’t even recommend insulin pumps to any of his patients.

I observe that there are more ways for a pump to potentially mess up your glucose than a syringe and vial of insulin.

Let’s take a look:

The syringe needle could break off (although it has only happened to me once).

I can’t think of more possible ways a syringe can go wrong.

The vial of insulin could be dropped and broken (I’ve dropped vials everywhere and luckily never broken one).

The pump itself is an imperfect machine which can go wrong (it may not go wrong, but the point is the potential is there-and I know it happened to me for no apparent reason more than once-a total mood killer when you hear the mad beeping).

The pump’s tubing can have air bubbles which cause high blood sugar if not caught in time. You bolus for a meal and you think you are getting insulin when in fact all you got was air. (This also happened to me a couple of times, enough to infuriate me all the way to China). The tubing can also knot and prevent insulin from reaching you. (I hear this often happens to active children and teens).

The pump’s battery might run out (obviously it warns you well ahead of time but, it is another thing to deal with).

You know, some people have told me, “well, at least with a pump you don’t have to carry anything around”.

I’m sorry, did I hear that correctly? Does this mean you don’t carry around some form of sugar, emergency glucose gel, or glucose testing device?

For me, adding a small batch of syringes and a vial of insulin to the above required items is too easy.

Something I found negative in a pump was only an issue when tied to a specific person’s tendencies. I call it being, “trigger happy”.

I gained a lot of weight when I first got on the pump the summer before 11th grade. I was so excited to have insulin on me at all times and had heard the pump pitched to me as a way to eat whatever, whenever I wanted. (Obviously not good advice.) Problem was, I snacked just because I could do it so easily. I also would give insulin when I suspected a high blood sugar and instead of testing first, I gave insulin with the pressing of a few buttons. It was just too easy.

Now obviously this may not be you or most people. Yet, I know I’m not the only one this happened to and honestly, I felt very free when I switched back to shots. I thought twice before throwing something in my mouth because I had to give an injection for it. I felt relieved that I was no longer addicted to the all too convenient buttons on the pump. Again, I recognize this isn’t an issue for everyone.

Some people may feel that they enjoy the convenience of hitting buttons and enjoy snacking often. Remember though, the more often you give insulin, the higher your margin of error due to a higher rate of incidence and the more unstable blood sugars you will have throughout the day. This is scientific fact-not my own idea, and it has been talked about before.

I also wonder that if because insulin pumps make certain people so much money, insurance companies, doctors, and hospitals all end up promoting them over shots. Just a thought.

Let me reiterate again that I am not against the pump. If you have one and control your blood sugars well with it then that is awesome and I couldn’t be happier for you! I am simply making a case for the cheaper, not-so-nifty, yet always reliable syringe which is so often made to look as the inferior alternative left for poor or unfortunate diabetics.

Thanks to syringes I give the exact amount of insulin I am intending on giving-every time. This is priceless for me. The fact that I can keep things simple and achieve great glucose numbers without something attached to my body is freeing for me. I just want others to know that if they cannot try out a pump, don’t despair! You can still manage your diabetes just as well with shots-if not better. The goal for all of us diabetics is the same. We deserve to freely choose how we reach that goal.

I know this struck some nerves so lets talk about it. Just leave a comment :)

I began having allergies over a decade ago as a teenager. I happen to be allergic to trees, grasses, molds, dust mites, cats, dogs, and different foods. I get allergy shots every week. Because of these year round indoor and outdoor allergies and a deviated septum, I lived out 10 full years with ongoing sinus infections. I was given so many courses of antibiotics those antibiotics no longer do the trick. The diabetes doesn’t respond well to infection so for years I was miserable in more ways than one.

Then one day an Ear Nose Throat (ENT) doctor steering me away from surgery had me try a sinus rinse by NeilMed. You can go to their website here. Basically, this squirt bottle comes with packets of special solution for your sinuses. You fill it with sterile or distilled water, pour in the powder from a packet, give it a shake, and you squirt up one nostril at a time while leaning over the sink. Sounds gross, but when you feel the mucus you haven’t been able to get out just flowing out (eww, I know) you will never go back.

Why? Because, you will feel immediate relief. Right away the tension in your sinuses is relieved and your headache relaxes. You can breathe through your nose and feel clean and clear. It gets better! If you have a sinus infection and do this several times a day for a week, I promise your infection will be gone or almost gone by the end of the week.

Taking antibiotics messes up the balance of good and bad bacteria in your gut and weakens your immune system so you are more likely to develop another infection or catch a virus.

Antibiotics are great if you have a life threatening infection and wham! It saves your life. What happens if you are in this position but, have taken too many antibiotics for small infections? What if the bacteria in your body resists the antibiotic? Uh oh, not good if you need life saving.

I have been using the Neil Med sinus rinse for three years now and haven’t had any more sinus infections. As soon as allergies start overwhelming me I start rinsing a couple times a week (which takes 2 minutes) and voila! No, infections here. Glucose numbers stay where they should. And I feel great.

I share this with you all because I wish I had known about the rinse long ago. Instead, I had to suffer through many years of chronic pain and sinus infections (and I missed a lot of school and work, too). But, you don’t have to.

So, if you have any kind of allergy issues, sinus problems, work inhaling dust or chemicals or smoke, you should try a nasal rinse. It is cheap, effective, and safe. Reminder for fellow diabetics: during an infection, try extra hard to keep glucose levels steady to help your body fight the infection.

Has anyone tried a sinus rinse? Did it work for you? Let us know in the comments!

Happy allergy season to ya,

Sysy

*****IMPORTANT*****

Do not use tap water for your sinus rinse because people have died from doing this when they contracted brain eating amoebas that entered the brain through the sinuses.

I spent years as a type 1 diabetic feeling real confident about how I could do everything a non-diabetic could do.

Then I learned I couldn’t fly a plane or go into the army. Then I realized being pregnant would be quite challenging and so would going to the beach with an insulin pump…the list goes on and on- as you know.

Thus I lost my proud mojo for a while. And honestly it falters from time to time but, on the whole I now focus on embracing being different.

If I were to continue fighting against the fact that I’m different from most people on earth due to my type 1 diabetes I think my health would suffer.

So here are a few ways you might “embrace being different” as a diabetic:

Demonstrate to others how awesome you are by the way you handle your diabetes care. When I give an insulin shot I purposely make it look painless and easier than brushing teeth. Others wince and I’m a diabetic diva.

If you wear a pump, get creative with how you wear it and strut your stuff. In other words, don’t worry about hiding it. Be proud that you have the guts to let it show (because hiding it is a pain in the butt) and allow your confidence to speak for itself. Read How to rock the outfit and the insulin pump

Be positive and see opportunities. See how being diabetic can be a good thing. I know this is hard but, it is possible. The more you try the easier it will be, I promise. Check out the 5 things I have gained from having diabetes to get you started thinking positive.

When you have to eat with a group of people and you feel left out because of your diabetic diet, hold your pretty chin up and smile. Think to yourself how healthy you are and will be if you continue staying on track. Focus on good conversation-not good food.

When you must refuse a dessert from your critical M.I.L. who never remembers your diabetes, don’t explain that you can’t have it because of your diabetes, say something witty like: “You’re son and I both enjoy my figure this way, I wouldn’t dream of ruining it with that-but thanks!” (smile and turn around).

Become an expert diabetic and you’ll not only benefit yourself, you’ll wow people with your medical jargon. My friends and family use me as go to girl for any health related questions/issues they’ve got. Its nice.

How do you embrace being different as a diabetic? We are after all…different diabetics right? Do share.

I am a huge proponent of almost every diabetic taking full control of their diabetes management. Learning about insulin and the relationship between it, exercise, and diet is not above most people’s heads.

I’ve had diabetes since age 11 and early on a few doctors encouraged me to learn all about my diabetes and become an “expert” in it. This is because realistically I would not have a doctor with me throughout daily life and thus needed to have the knowledge to make all of the proper decisions regarding my diabetes.

Who is the expert?

Lately however, I have run into several doctors who do not seem to feel it necessary for me to manage my diabetes. They believe they should be doing it for me. With all due respect to doctors, this is absurd.

Decisions need to be made on a constant basis by diabetics and so I don’t know what some of these doctors might expect, that I call them every time I am going to eat or exercise seeking guidance? They expect me to use the same dose of insulin all the time when I very well know I need to tweak it on a daily basis depending on my daily circumstances. (I don’t expect a child to do this by the way)

Strict control vs. being “safe”

It has been well documented in many medical journals how important it is for a diabetic to maintain very strict control. This is one’s best shot at avoiding complications. Yet, many doctors out there are telling their patients to avoid strict control.

Why? Perhaps because some studies have come out saying tight control equals a high risk for hypoglycemia. Personally, I’ve had my share of lows in the past 15 years and have never once passed out or not been able to help myself. Unfortunately however, other diabetics have passed out-many times. Telling these people to loosen up their tight control isn’t the answer. The answer is to evaluate diabetes lifestyle habits and to have a patient check glucose more frequently. If one is doing the right things and monitoring glucose often, a severe low episode has a much lower chance of occurring.

How much do doctors know about diabetes?

I had a doctor who referred me to a diabetes specialized internal practitioner. This specialist asked me why I took both lantus and humolog insulin. Believe it or not I had to explain to this gentleman why both of these insulin types were required (I use injections, not a pump). Insulin is a basic thing with diabetes. If he doesn’t know something this basic I don’t necessarily feel too secure under his “diabetes management”.

Don’t get me wrong, I like doctors. In fact I love them. I realize now I should have become one seeing how articles in the New England Journal of Medicine excite me more than shopping, chocolate, and music-combined.

I just feel many doctors are told one thing in medical school when there is a different reality. They have all the best of intentions about helping people and yet, many diabetics feel as if their doctor doesn’t know enough about diabetes and doesn’t recognize their own knowledge about the disease gained through experience. Experience does teach and should count for something. My 15 years of experience taught me things that only recently are being exposed as “new information” about diabetes. I often read articles and think “I found that out 10 years ago…”

Conclusion

Basically, patients need to come forward to their doctors with confidence about what they know about their diabetes management and doctors need to listen with humility. Doctors should be aware that their studies did not cover more hours on diabetes than many diabetics have spent studying and living with their disease.

Between patient and doctor there should ideally exist more of a partnership and diabetes will be much better controlled. It is best diabetics be regarded as the ultimate expert of their own disease and assume responsibility for their actions. It isn’t fair to expect doctors to give us good diabetes control. We must do the work.

Only once I became the expert on my body and my diabetes and took full responsibility of for my actions did I finally achieve better control.

I had just thought proudly to myself a few days before this incident, “Great job, Sysy, you’ve been a diabetic for over 10 years and never been to the ER!” Well, one Saturday morning, I get up at 7am as usual to give my lantus insulin shot. In case you are not familiar with lantus, it works as your basal. I take one shot of lantus every morning at the same time and if I have given the correct amount (which for me is about 20 units), you should have steady glucose throughout the next 24 hours, say if you don’t eat or give any fast acting insulin.

Well my fiancé at the time had bought me a mini fridge to keep in my room so that I wouldn’t have to go upstairs for the lantus shot. This was so sweet of him because on Saturday and Sunday mornings it allowed me to wake up at 7am for the shot and go back to sleep for a while. Going upstairs would really wake me up and not allow me to drift back into sleep.

Now, the night before I was out late. So while I am giving myself my 20 units of lantus, I have only had about 4 hours of sleep. As I pushed in the injection I suddenly looked at the bottle of insulin I had taken out. It wasn’t the lantus, it was the fast acting humolog!

I checked and my blood sugar was 110. This gave me no extra time. I closed my eyes for about 60 seconds. I thought to myself, “Ok Sysy, in 15 minutes 20 units of fast acting insulin is going to start rushing your system. You need to buy time and get to the hospital. At the time, I lived at home with my family. I knew that telling them this news would illicit panic. So I got dressed, brushed my teeth (come on! I want fresh breath even in an emergency!) Then I ran upstairs to the kitchen, drank the first thing I found with sugar-chocolate soy milk-worked for me! I gulped 2 glasses of the stuff. I then ran out the door and drove approximately 30 seconds (literally) to the corner gas station. I went in and bought candy and a couple bottles of grape juice (grape juice has more sugar than any other juice).

I then went back to the car (don’t worry I didn’t drive anywhere), I began gulping down the grape juice while I dialed my fiancé (who lived 5 minutes away). Luckily, he answered his cell phone. I began telling him calmly, “Alex, I am going to need for you to wake up and be really alert to what I am about to say.” He says, “Yeah, yeah, I am awake”. His voice sounded far away and on a lazy cloud so again I said, a little louder, “Alex, I need your help but I need for you to really be awake and paying attention”. He finally spoke to me in a voice of someone who was no longer in a dream so I explained to him what happened. He is better at math than me so I asked him what 20 times 15 was (because I need about 15 carbs per unit of insulin). The number he came up with was very scary and I knew I couldn’t save myself. I told him to immediately come to the gas station and pick me up to take me to the hospital.

He arrived in about 6 minutes. (Gotta love a man that can move fast!) By this time I had downed two large bottles of grape juice (which was very nauseating) and was now starting on the candy. My brain felt like it was swelling inside my head and I was getting sleepy. It also felt like my veins would explode. On the way to the hospital I checked my glucose and it was 98. 98! I could not drink anymore liquid without fear of vomiting (and making things worse) and I could barely chew the candy. So I called 911 to let someone know to expect me at the hospital entrance. The operator asked me if I was in an argument with my boyfriend and if this was a suicide attempt. (Very disheartening when all I needed was for her to believe me and HELP!) I was still very aware of everything and chose to fight what I was feeling and calmly explained the woman what happened. She suggested an ambulance meet me on the way to the hospital and transport me the rest of the way.

So that’s what we did. We waited 12 minutes for the ambulance. In the meantime I was scared I might die over the dumbest most preventable mistake ever and my fiancé and I began to panic. I saw tears in his eyes and felt so sad for him and my family and friends. I just kept trying to eat candy.

On the way to the hospital the medic checked my glucose and told me it was a little over 200. I did buy myself time! All that sugar worked! In the ER, the nurses didn’t really take my situation seriously. Each time they gave me intravenous glucose was because I had checked my blood sugar on my own and I had alerted a nurse it had dropped to 80 or 70. I felt they didn’t believe I really gave all that fast acting insulin. They would tell me they would check me in an hour and within half an hour I would do the safe thing and check it myself and find it plummeting dangerously, to which they would come in and say, “Oh, it’s really dropping, you need more glucose!” This went on for about 6 hours. Amazing, when you consider the makers of humolog claim it only acts for 2 hours-no matter the dose. (Hmm…)

I really felt like I redeemed myself that day. I made the initial mistake of giving the wrong insulin type but, I took responsibility for myself in the ER and I would hate to have seen what would have happened had I not done so. I found that in 30 minutes my blood sugar dropped more than 10 times what the hospital staff expected and had I not checked my own glucose repeatedly, I am sure I would have gone into a seizure or worse.

I came away that day with the conclusion that nurses and doctors are not as educated in certain details about type 1 diabetes as one might expect or hope. I also quit going to bed so late and made sure I was up and alert before giving any insulin.